The nurse is preparing to administer medications for an eight-month-old infant with heart failure. The infant has a blood pressure of 114/66 mm Hg, apical pulse of 88 beats/minute, and respirations of 30 breaths/minute.

Which medication should the nurse withhold until the healthcare provider is notified?

Digoxin.

Furosemide.

Hydralazine.

Enalapril.

Answer and Explanation

The Correct Answer is A

For an eight-month-old infant with heart failure, the nurse should withhold digoxin if the infant's apical pulse is less than 90 beats/minute and notify the healthcare provider. In this case, the infant's apical pulse is 88 beats/minute, so the nurse should withhold the digoxin and notify the healthcare provider.

Furosemide ( B), hydralazine (C), and enalapril (D) do not have specific parameters for withholding based on the infant's vital signs.

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Correct Answer is D

Explanation

To ensure the cooperation of a preschooler during an assessment of lung sounds, the nurse can allow the child to use a stethoscope on a stuﬀed animal. This helps the child understand what is happening and feel more comfortable with the procedure. Having the child blow a cotton ball (A), placing a toy in the child's hands (B), and oﬀering bubbles (C ) may distract the child but do not directly involve them in the procedure.

A. Oﬀer a pacifier for non-nutritive sucking. B. Use sterile technique during feedings. C. Ensure placement of the enteral tube with an abdominal x-ray. D. Speak to the healthcare provider about instituting physical therapy.

Correct Answer is A

Explanation

To maintain normal growth and development of an infant with a repaired gastroschisis who is receiving parenteral nutrition and continuous enteral feedings, the nurse should include oﬀering a pacifier for non- nutritive sucking in the plan of care. Non-nutritive sucking can help promote the development of the infant's oral motor skills and support normal feeding behaviors. The other options (B, C, and D) are not directly related to maintaining normal growth and development in this situation.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing the lung sounds of a preschooler. Which action should the nurse implement to ensure the child's cooperation?

Correct Answer is D

Explanation

Correct Answer is A

Explanation

A mother brings her 2-month-old to the well-baby clinic. She states that when she kisses her baby, the infant's skin tastes salty. The nurse should prepare the mother for what standard diagnostic test to screen for cystic fibrosis (CF)?

A 7-year-old child is admited to the hospital with a diagnosis of acute rheumatic fever. In obtaining a health history from the child's mother, the recent occurrence of which illness is most significant?

During her sports physical examination, 15-year-old female requests oral contraceptives. She explains that she is sexually active and does not want her parents to know. Which action should the nurse take?

The nurse is caring for a child with hypoparathyroidism who demonstrates a carpal spasm when pressure is applied to the upper arm. Which laboratory value should the nurse review?

The nurse is providing teaching to a school-age child with left femoral osteomyelitis and the child's parent prior to discharge. Which instruction should the nurse provide related to the initial phase of treatment?

The parents of a child with Wilms tumor ask the nurse why surgery is necessary before a biopsy is performed. Which information should the nurse provide?

The nurse is assessing an infant with aortic stenosis and identifies bilateral fine crackles in both lung fields. Which additional finding should the nurse expect to obtain?

The nurse is assessing a 6-month-old infant. Which response requires further evaluation by the nurse?